Will Trump Take Steps to Rein in Drug Prices?

As Vice President-elect Mike Pence takes control of the transition team, a question about the next president’s health policy emerges: Will President Donald Trump follow through on a campaign promise to bring down prescription drug prices?

In March, candidate Trump called for letting Americans import drugs to save money, and for changing the rules to let Medicare negotiate better deals. But the new transition website, www.greatagain.gov, features a page on healthcare reform that makes no mention of prescription drugs, even though polling consistently shows this is Americans’ top healthcare worry.

An advocacy group, the Campaign for Sustainable Rx Reform, urged the new administration to put prescription drug prices on the front burner. “One issue that came up again and again on the campaign trail is that Americans are tired of skyrocketing drug prices,” said John Rother, the Campaign’s executive director, in a statement.

Although the silence on drug prices is gaining attention, there’s been less notice paid to the transition team’s tie to the pharmaceutical industry. While New Jersey Governor Chris Christie was the public face of the transition for much of the campaign, the day-to-day work was quietly led by Rich Bagger, Christie's own former chief of staff, who took leave from his post at Celgene to lead the effort. Bagger was a longtime member of the New Jersey legislature and worked for 16 years at Pfizer.

In late October, the Kaiser Health Tracking Poll found that 2 issues relating to drug costs topped the list of voter concerns about healthcare—more so than repealing the Affordable Care Act (ACA), which is first on the incoming administrations’ agenda. The Kaiser poll found that 74% of Americans want the new president and Congress to ensure that those with chronic conditions have access to high cost drugs, and 63% favor general steps to control drug prices.

Repealing the core mandate of the ACA—the requirement that all Americans buy healthcare or pay a fine—was a priority for 38% of Americans, the poll found. In polls taken over a 6-year period, Kaiser has found the opinion on the ACA consistently divided along party lines, although consumers’ views on individual elements tend to shift when they are asked about pieces of the law.

On the topic of prescription drugs, there’s less disagreement. Frustration with drug prices cuts across the ideological spectrum, although support for government action is somewhat stronger among Democrats. Equal-opportunity fury is reflected in bipartisan outrage over soaring EpiPen prices, where Senator Chuck Grassley (R-Iowa) has been a vocal leader.

In his March position statement on healthcare, Trump said he wanted to “remove the barriers to entry into free markets for drug providers that offer safe, reliable, and cheaper products.” The Pharmaceutical Research and Manufacturers of America issued a statement at the time opposing the import proposal, saying it would pose a threat to patient safety.

In other statements, Trump blamed the pharmaceutical industry for Medicare’s inability to gain negotiating rights on par with the Veterans’ Administration. He vowed to change the rules to give Medicare a stronger hand. On this issue, Trump agreed with Democratic nominee Hillary Clinton.

“We don’t do it," Trump said. "Why? Because of the drug companies,” the Associated Press reported.

On the transition website, however, the only priority item concerning drugs is a call to “reform the Food and Drug Administration, to put greater focus on the need of patients for new and innovative medical products.”